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Each week we will put a spotlight on one of the people the SpeechRight Speech and Language Therapists have been working with. This will give an insight into the types of difficulties we support and what goes on in a therapy session.

Week One Spotlight

Name:Tom

Age:4:0

Difficulties:Speech Sounds. Tom has lots to say but his speech is unclear so listeners cannot understand his spoken sentences.

Background:Tom had an initial assessment. He showed that his speech sound development was disordered. This meant that the speech errors that he was making were not ‘typical’ errors that lots of children make as the speech sound system develops.

Examples:

‘book’ became “ut”

He deleted the first sound ‘b’ from the word and changed the ‘k’ to a ‘t’ sound.

‘pea’ became “pay”

He changed the vowel ‘ee’ to ‘ay’

‘tap’ became “da”

He changed the ‘quiet’ ‘t’ sound to a ‘loud’ ‘d’ sound and deleted the final sound from the word

Hearing:All assessments passed

Session:Therapy 1 with Mum, Tom and Emma.

This first session was all about getting to know Tom and checking that he had stored the correct information about sounds and words in his head.

We built a paper ‘spider’ together and at the end of each of the spider’s legs I found something out about Tom (who his best friend was, where he liked to go and what his favourite food was). This gave lots of opportunity to hear Tom’s speech sounds in his talking. It also gave Tom chance to make a spider with 8 eyes!!

Next we checked out if Tom could hear the difference between some of the sounds he was confusing. We had ‘t’ skittles and ‘k’ skittles. I would say a ‘t’ or ‘k’ sound and Tom had to roll the ball to the correct set of skittles. Tom needs to realise that the ‘t’ and ‘k’ sounds are separate sounds and have stored this correctly in the language system in his head. If he does not realise that they are separate sounds, then it is no wonder he will confuse ‘t’ and ‘k’ in his talking.

After skittles, Tom became the ‘teacher.’ We looked at a picture book together and I picked out different words for my friend ‘Sam the Puppet’ to say. Sometimes, Sam would say the words the ‘right’ way but sometimes he would say them a ‘silly’ way. Tom, using a ‘thumbs up’ or ‘thumbs down’ action had to let Sam know how he was doing. It was important for Tom to be the teacher because Tom needs to understand the correct way to say a word so he can send the right instructions to his mouth to produce the word.

Finally, we finished by making some ‘silly faces’ in the mirror using some chocolate and strawberry sauces. We all (mum included!) put sauces in different places on our faces (tip of our nose, side of our lips, on our chin) and then we each had to try and lick the sauces off with our tongues. This let us look at how quickly and easily we could move our tongue. When we say words and sentences, we need to move our tongue quickly into lots of positions in our mouths to make the speech sounds. We then ended with a game of table football. It was Tom against Mum and I and we each had a straw which we had to use to blow a small chocolate ball into our goal. When we speak, we use the airflow coming from our lungs. Using straws shows how strong our airflow is and if we can control it. Sadly, Tom won the football match 5-3!

Tom and Mum then left with a pack of activities/resources to continue these games at home. Tom’s next session is in a week but he will be having daily therapy from mum as they play one of the games together.

In the Spotlight next week will be Emilia. Emilia is 3 years old and has been referred because she is only using 15 single, spoken words.

‘Oral vocabulary’ refers to the range of words which your child can understand when they hear them and can use when they are talking.

In this industry and as Speech Therapists in Nottingham we’ve seen that research shows that your child’s vocabulary is very important. It is directly linked to their later school success, impacting on their reading, maths and behaviour skills. Furthermore, without understanding and using a range of different words, your child’s thinking skills and knowledge about the world are restricted.

So what can you do to help Develop Your Child’s Vocabulary?

You need to think both about what you are saying to your child and how you are saying it.

Children aged 24-36 months need to hear a variety of ‘sophisticated’ words ie. they now know lots of common words so want to learn more difficult words e.g. “exhausted” instead of ‘tired’, “sprinting” instead of ‘running.

Children aged 36-48 months need to hear about past and future events and explanations ie. “Oh we can’t put them in the bus because the bus is full of bricks” “Oh yes, we had popcorn at the cinema. Do you remember?”

HOW to Say It

With our multitude of experience from being speech therapists in Nottingham, we have found that there are a range of different strategies to show you how to introduce new words to your child and develop their vocabulary skills at home:

Talk about Things in the Here and Now

Your child is more likely to engage with you and learn if they are interested. So provide commentary about what you and your child are doing e.g. “We’re drinking hot chocolate” “I’m eating pasta and sauce” “We’re walking to the shops”.

Think about changing the words and phrases you use depending on your child’s age/level of development e.g.

“We’re sipping hot chocolate” “We’re strolling to the supermarket”.

“We need to have a hot chocolate because it’s cold outside” “Do you remember when we went to the supermarket and saw Tom?”

Link new words with words that your child already knows e.g. “There’s a jet. A jet is a very fast aeroplane.”

Be face-to-face with your child when talking to them, this is something that seach therapists have found extremely useful, as this will help them to look at you and focus on what you are saying.

Spend time playing ‘pretend play’ with your child e.g. pretend that you are going on a picnic, pretend you are at the doctors, pretend that you are at school. Take on the role of your character (e.g. doctor) and say phrases and words that a doctor would use ie. “How hot do you feel? Let me take your temperature”. “Open your mouth wide…say ‘ahhh’” “Let me put a bandage on your poorly leg” this is also something that search therapists will do along other assessments.

Be visual when talking to your child ie.

Hold or point to the object you are talking about e.g. “Look at all the dark clouds (point) in the sky”

Gesture the action you are saying e.g. “We have got to drive to the shops”.

This will help to grab your child’s attention so that they are concentrating on what you are saying and it will help them to understand the new words.

Repeat, repeat, repeat. Give your child lots of opportunities to hear the new words. Children need to hear a word said a number of times before they start to use it correctly in their own speech.

‘Babbling’ is when your child is playing around making different speech sounds e.g. “baba”. The utterances are not yet recognisable words and your child is not intentionally trying to send you a message but, instead, they are having fun producing different sequences of sounds.

Some recent research completed by McGillion et al (2017) highlights the importance of babbling in predicting when a child will produce their first words.

In the study, 46 English-speaking children, were chosen. Their babble and pointing skills were assessed whilst they were 9-18 months old. They were regularly recorded during free-play at their homes and parents/carers also kept a diary recording any new communicative behaviours that their children displayed.

The results showed:

Children typically started babbling 3 months before they started pointing.

Most of the children typically started babbling at 10 months of age. By 15 months of age, all the children were babbling and, by 18 months of age, all the children were pointing.

The start of babbling did predict when a child would use first words

The start of pointing predicted the range of words which the child would understand at 18 months.

How does Babbling Encourage a Child’s First Words?

Makes it obvious to the child what communication is about: it is a two-way process with one person speaking, the other person listening and then responding.

Encourages the child to continue to practice making sounds

Helps the child to realise the role of first words

How does Pointing Predicts a Child’s Understanding of Words?

Pointing requires a child to have developed ‘joint attention’ (the ability to share attention with somebody else). ‘Joint attention’ is a key skill for successful communication so pointing gives a child lots of practice with this skill.

Carers respond to their child’s pointing by commenting and labelling what they are pointing to. This helps to build their child’s understanding levels.

What Can You Do to Develop Their Childrens’ Babbling and Pointing Skills

Give your child the opportunity to babble/point – pause and wait before you begin to speak to see if your child will babble or point. Sometimes, we can be so keen to talk to our child and give them lots of language models to hear that we do not give them time to communicate with us.

Imitate your child’s babble – copy the sounds that they are making. This will make your child feel powerful as they know you are attending to them and it may also encourage them to continue to babble. This will then set up a good two-way interaction with both you and your child taking turns.

Respond to your child’s pointing – if your child points to something (with or without vocalising), follow their point and comment/label it using one or 2 words e.g. “Car” “banana” “mummy’s shoes”

If you have any concerns about your child’s sound-making/babbling/pointing skills, please feel free to contact Speech Right to speak to one of our speech and language therapists here in Nottingham, who will be happy to provide advice.

Do you think that your child does not always understand what you are saying? Do they;

Respond slowly or not at all when you speak to them

Change the subject or go off tangent to the topic of conversation

Wait and follow what others do when they are spoken to

Have poor attention and spoken language skills.

Here at Speech Right, the speech therapists would recommend the following strategies as being useful to use:

Make Sure You Have Gained Your Child’s Attention Before Speaking To Them.

If your child is not concentrating on what you are saying, then they will not be able to listen to and understand what you mean. Wait for your child to look up from the activity they are doing and make eye-contact with you before you speak.

Reduce Your Language Level To That Of Your Child’s

If your child is using spoken phrases of 2 words, make the sentences you use with your child 2-3 words long. This might mean, rather than saying “Go and get your shoes and coat and put them on” using “Get your shoes” “Put your shoes on” “Get your coat” “Put your coat on” would be better.

Match The Words That You Use To The Words That Your Child Uses.

If you use language which is too complex, your child will not be able to workout what you are saying e.g. when a child is developing their understanding of ‘transports’, it wil

As speech therapists in Nottingham, we are often introducing Makaton to families to support their children’s’ communication skills.

What is Makaton?

Makaton was devised by 3 speech and language therapists. It is a language programme that uses signs and symbols to help people communicate. The signs are based on signs from British Sign Language (the official sign language for people who are deaf or who have a hearing impairment) and the symbols are simple, black and white line drawings.

The CBBC ‘Something Special’ programme uses Makaton.

Who Uses It?

As a speech therapist, I have used Makaton with a range of different communication problems. By signing and symbolising the environment, adults are:

Encouraging children to attend to what they are saying (the child is hearing AND SEEING something)

Helping the children to understand by adding a visual clue to support their spoken words.

>Giving children confidence to support their own speech with gestures/signs as the children are surrounded by adults who are doing the same.

Speech Right has used Makaton successfully in therapy with:

Children who are delayed in using spoken language

Children who have difficulties understanding English

Children who are struggling to produce clear speech

Children with attention and listening problems

Children who have social communication difficulties

Children who have English as a second language

Can Makaton Be Used AT Home?

Yes, even if your child does not have any speech and language difficulties. Speech Right actively encourage families to use Makaton as research has shown that using signs and symbols actively encourages the development of speech and language skills (www.makaton.org.uk).

To start:

pick some key words which you use daily with your child and begin to sign the word everytime you say it.

Watch Justin and Mr.Tumble on ‘Something Special’ together with your child.

For further information about Makaton, please feel free to contact Speech Right and the speech therapists here in Nottingham will be happy to help.

As a speech therapy practice in Nottingham, Speech Right is often asked by parents and teachers, how they can support children with attention difficulties. So, with 10 plus years as a speech therapist in Nottingham, I have written some of my key strategies/ideas for helping children with attention difficulties below;

Say the child’s name before speaking to them. This will help the child to focus their attention.

Encourage the child to “look and listen.” Get the child to stop the task that they are doing and look at the speaker.

Get down to the child’s level when speaking to them. It will be much easier for them to attend to what you are saying, if you are closer to them.

Speak slowly and clearly. The child will then be able to focus on each word that is being said.

Support your spoken utterances visually e.g. gesture/use objects/use pictures/use symbols/use Makaton signs for key words in the utterance. The child will then both hear and see the utterance which will help to gain and maintain their attention.

If you would like advice on how to use Signs and Symbols with your child/in your classroom, please feel free to contact Speech Right and one of our speech therapists in Nottingham will be happy to help.

Talk at the child’s level of understanding. Try to use the same length of utterance as the child is using. If the child is not able to understand what is being said, their attention will be lost.

Make use of visual timetables and set routines. The child will then understand what is going to happen which will mean they can then focus their attention on the activities.

Again, if you would like advice on using and making visual timetables, feel free to contact Speech Right and one of our speech therapists in Nottingham will be happy to help.

Use short activities which have an obvious ‘start’ and ‘finish.’ This will make it clear to the child where and for how long they need to attend for.

Try to use these strategies at home/nursery/school to support children’s attention skills. The speech therapists at Nottingham’s Speech Right can offer further advice/strategies/activities if you still have concerns about your child’s attention skills.

Ensure that your child is looking and listening to what you are saying. If needed, wait for them to finish their activity and look up towards you before you begin to speak.

Use gestures and actions alongside your speech to keep your child’s attention and help them to understand what you are saying.

Talk about things that are happening in the ‘here and now’. Comment on what your child is doing so that your child can match the words to the objects e.g. “Jack is sitting on the chair. Jack is putting his shoes on. Jack has got his coat.”

Repeat back and add a word on to what your child says to help them put more words together e.g.
Tess = “there’s a car”
Adult = “yes, there’s a FAST car”

Give your child lots of opportunities to hear clear models of speech to support them to develop clear words e.g.
Ted = “wat the tar”
Adult = “yes,WASH the CAR”

Give your child lots of time to think about and say their spoken utterances. Try not to make your child feel rushed to get their words out or they will put extra pressure on their language system which might overload it.

So far, one specific cause of stuttering has not been identified. Research is, however, revealing different explanations for the condition and looking at possible treatments. Norman Miller’s ‘The Science of Stammering’ article published on The British Stammering Association website (www.bsa.org.uk) gives a very good overview of the current findings from this research.